Health

This briefing summarizes findings from the mid-point of the Community Approaches to Epidemic Management in South Sudan research project. The project is run by the Rift Valley Institute (RVI) and funded by the UK Foreign Commonwealth and Development Office (FCDO) via the East Africa Research and Innovation Hub (EARIH). The project, which began in response to the global coronavirus pandemic, is designed to document how communities across South Sudan have created systems and structures to control the spread of epidemics and infectious diseases in the country. It builds on a rapid response research study conducted by RVI in April this year: Responding to COVID-19 in South Sudan: making local knowledge count.

This briefing presents time-critical findings and suggestions for action. A full report will be published at the conclusion of the project that will present geographically specific evidence including detailed community methods of infectious disease management.

Major infectious disease outbreaks in low-and middle-income countries can have serious long-lasting impacts that go beyond the direct impact of the disease, to include secondary social, economic, health and political impacts. These impacts can result from response and control measures such as quarantines, travel restrictions, and social distancing, and can be short or longer term. This rapid review synthesises evidence on the secondary impacts of response and control measures to major disease outbreaks (e.g. SARS/H1N1/MERS/Ebola etc.) in low- and middle-income countries with weak health systems or in pre-existing cries. The available evidence regarding the secondary impacts of response and control measures to major disease outbreaks in low- and middle-income countries finds that they include socio-economic impacts, secondary health impacts, and political and security impacts. A second companion paper (Kelly, 2020) looks at lessons learned from responses to these secondary impacts. These include inter-sectoral responses and co-ordination between NGOs and national governments, the importance of health systems strengthening, and cultural awareness to mitigate against stigma and the marginalisation of specific groups.

This report provides a comprehensive summary of global progress on improving water, sanitation, hygiene, waste management and environmental cleaning (WASH) in health care facilities and is intended to stimulate solution-driven country and partner actions to further address major gaps. It illustrates how stakeholders in the WASH and health sectors are increasingly working together in specific countries, with the ultimate aim of delivering safe, quality essential health services.

In the context of the current Ebola outbreak in the Democratic Republic of Congo (DRC), May 2019, this brief summarises key considerations about bushmeat (meat derived from wild animals for human consumption)in the context of preparedness activities in South Sudan. The brief details the socio-cultural and socio-economic significance of bushmeat amongst at risk communities and perceived risks of Ebola transmission through bushmeat. Its geographic focus rests on South Sudan’s south-western border with the north-eastern border of the DRC, where Yambio is the state capital and primary population hub. Key considerations and recommendations are tailored for this specific area, and may not be necessarily generalisable for other parts of South Sudan or beyond.

The brief is presented in two sections. ‘Section A’ focuses on bushmeat in light of the immediate risk of Ebola transmission from the active outbreak in the DRC to South Sudan (i.e., cross-border human-to-human transmission and in relation to the bushmeat trade). ‘Section B’ focuses more broadly on bushmeat in this specific geographic area, and the longer-term risk of a new Ebola or other infectious disease outbreak in South Sudan, as related to local bushmeat practices (i.e., unrelated to the current outbreak in DRC). The structure of this brief is designed to separate these issues and to support response partners to differentiate between the priorities for immediate preparedness activities underway in South Sudan and longer-term prevention actions.